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Pharmacology Exam 3 KS > Cancer Drugs > Flashcards

Cancer Drugs Flashcards

1
Q

MOA for Alkylating Agents

A

Act by changing structure of DNA in cancer cells

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2
Q

MOA for cyclophosphamide (Cytoxan)

A

attaches to DNA and disrupts replication

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3
Q

MOA for Antimetabolites

A

Act by disrupting critical pathways in cancer cells

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4
Q

MOA for methotrexate (Folex, Mexate, others)

A

blocks synthesis of folic acid (vitamin B9) to inhibit replication

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5
Q

MOA for Antitumor Antibiotics

A

Act by inhibiting cell growth through cytotoxicity

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6
Q

MOA for doxorubicin (Adriamycin)

A

attaches to DNA.

Distorts double helical structure and prevents normal DNA and RNA synthesis

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7
Q

MOA for Hormones/Hormone Antagonists

A

slow growth of reproductive-related tumors

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8
Q

MOA for tamoxifen (Nolvadex)

A

blocks estrogen receptors on breast cancer cells)

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9
Q

MOA for Natural Products

A

Kill cancer cells by preventing cell division

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10
Q

MOA for vincristine (Oncovin)

A

cell-cycle-specific (M-phase) agent that kills cancer cells by preventing their ability to complete mitosis

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11
Q

MOA for Biologic Response Modifiers

A

Stimulate or assist client’s immune system to rid itself of cancer cells

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12
Q

MOA for interferons,

A

Slow spread of viral infections and enhance activity of lukocytes

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13
Q

MOA for interleukins,

A

 Stimulate platelet production in immunosuppressed clients
 Enhance capabilities of immune system
 Stimulate cytotoxic T cells
 Increase B-cell and plasma-cell production
 Promote inflammation

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14
Q

MOA for sirolimus (Rapamune) and azathioprine (Imuran)

A

Inhibit aspects of lymphocte replication

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15
Q

MOA for Antimetabolites

Immunosuppressant

A

Inhibit aspects of lymphocte replication

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16
Q

MOA for Calineurin Inhibitor

Immunosuppressant

A

Bind to calcineurin and disrupt T cells, to inhibit helper T cells

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17
Q

MOA for Cyclosporine (Sandimune, Neoral) and tacrolimus (Prograf)

A

Bind to calcineurin and disrupt T cells, to inhibit helper T cells

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18
Q

MOA for Glucocorticoid Steroids

Immunosuppressant

A

Inhibit inflammation

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19
Q

Glucocorticoid Steroids

(Immunosuppressant) are use for

A

Used for short-term therapy for severe inflammation

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20
Q

Side effects of cyclophosphamide (Cytoxan)…..

A

can cause significant bone-marrow suppression

immunosuppressant effects, thrombocytopenia
Nausea, vomiting, anorexia, diarrhea
Alopecia (hair loss), hemorrhagic cystitis

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21
Q

Side effects of methotrexate (Folex, Mexate, others) …. Antimetabolites

A

fatal bone-marrow toxicity at high doses
• Hemorrhage and bruising, low platelet counts
• Nausea, vomiting, anorexia
• Gastrointestinal ulceration, intestinal bleeding

22
Q

Side effects of doxorubicin (Adriamycin)

A

cardiotoxicity, dysrhythmias
Irreversible heart failure, lower blood-cell counts
Nausea, vomiting

23
Q

Side effects of tamoxifen (Nolvadex)

A

nausea and vomiting
• Association with increased risk of endometrial cancer and thromboembolic disease
• Hot flashes, fluid retention, vaginal discharges common
Development of cross-gender secondary sexual characteristics
• Common, yet distressing, side effects of sex-hormone therapy

24
Q

Side effects of vincristine (Oncovin)

A

nervous system toxicity, numbness and tingling in limbs
• Muscular weakness, loss of neural reflexes, pain
• Paralytic ileus, constipation, alopecia

25
Q

Side effects of interferons,

A

flulike syndrome in 50% of clients (diminishes as therapy progresses)
Headache, nausea, vomiting, diarrhea
Anorexia, depression, suicidal ideation.
With prolonged therapy, immunosuppression, hepatotoxicity, neurotoxicity

26
Q

Examples of Immunosuppressants

A

 Glucocorticoids
 Antimetabolites
 Antibodies
 Cacineurin inhibitors

27
Q

Antibodies

A

Basiliximab (Simulect) and daclizumab (Zenapax)
- Prevent acute rejection of kidney transplants
Infliximab (Remicade)
- Suppresses inflammation in autoimmune disorders
Muromonab –CD3 (Orthoclone OKT3)
- Prevent rejection of kidney, heart, and liver transplants
- Depletes bone marrow of T cells prior to marrow transplant

28
Q

Side effects of Calineurin Inhibitor

Immunosuppressant

A

75% of clients experience reduction in urine flow
over 50% will experience hypertension

Infections, headache, gingival hyperplasia, elevated hepatic enzymes , hypertension, and elevated hepatic enzymes

29
Q

cyclophosphamide (Cytoxan) is an example of a __________.

A

Alkylating Agent

30
Q

methotrexate (Folex, Mexate, others) is an example of ________.

A

Antimetabolites

31
Q

doxorubicin (Adriamycin) is an ______.

A

Antitumor Antibiotics

32
Q

tamoxifen (Nolvadex) is an ______.

A

Hormones/Hormone Antagonists

33
Q

vincristine (Oncovin) is an _______.

A

Natural Products

34
Q

Interferons, interleukins, monoclonal antibodies are examples of __________.

A

Biologic Response Modifiers

35
Q

sirolimus (Rapamune) and azathioprine (Imuran) are examples of ________.

A

Antimetabolites

Immunosuppressant

36
Q

Cyclosporine (Sandimune, Neoral) and tacrolimus (Prograf) are examples of ______.

A

Calineurin Inhibitor

Immunosuppressant

37
Q

Basiliximab (Simulect) and daclizumab (Zenapax) does what?

A
  • Prevent acute rejection of kidney transplants
38
Q

Infliximab (Remicade) does what?

A
  • Suppresses inflammation in autoimmune disorders
39
Q

Muromonab –CD3 (Orthoclone OKT3) does what?

A
  • Prevent rejection of kidney, heart, and liver transplants

- Depletes bone marrow of T cells prior to marrow transplant

40
Q

You’ll know it’s an antibody because it’ll have the suffix….

A

-ab….
Basiliximab
Infliximab
Muromonab

41
Q

Hormones other than tamoxifen (Nolvadex) may be …..

A

palliative rather than curative

Important that both client and family understand this limitation

42
Q

Antimetabolites

A

fatal bone-marrow toxicity at high doses

43
Q

Nursing Implications: Alkylating Agents

A
  • Discontinue if RBC, WBC, and platelet counts fall
  • Use caution with hepatic or renal impairment, recent steroid therapy, leukopenia, or thrombocytopenia
  • Hydrate clients with IV or oral fluids before starting chemotherapy
  • Advise clients to avoid crowds and those with respiratory infections
  • Be alert to possible development of blood dyscrasias
  • Monitor nutritional intake
  • Assess for nausea and vomiting
  • Be prepared to administer antiemetic drugs
  • Offer ice chips or ice pops to relieve mouth pain
  • Assess skin integrity
  • Monitor for signs of hearing loss
  • Inform clients of potential adverse impact on fertility
  • Alkylating agents range from pregnancy category C to X
  • Maintain strict medical asepsis
44
Q

Nursing Implications: Antimetabolites

A
  • Contraindicated in pregnancy, hepatic, cardiac, and renal insufficiency; myelosuppression; and blood dyscrasias
  • Avoid pregnancy for at least six months after therapy with category X drug
  • Adverse effects common to other antineoplastics may occur
  • Monitor for photosensitivity and idiosyncratic pneumonitis
  • Teach clients to use good oral hygiene and encourage mouth rinses
  • Monitor IV site frequently for extravasation
45
Q

Nursing Implications: Antitumor Antibiotics

A
  • Assess cardiac status—obtain baseline ECG
  • Assess for pregnancy and lactation
  • Produce same cytotoxic effects as other antineoplastics
  • Risk of hypersensitivity reactions exists as with other antibiotics
  • Changes in rectal mucosa contraindicate suppositories or rectal temperatures
  • Wear protective clothing (gloves, mask, and apron) when preparing drug
  • Monitor IV site because doxorubicin is a severe vesicant
  • Give drug through large-bore, quickly running IV; monitor for extravasation
46
Q

Nursing Implications: Hormones and Hormone Antagonists

A

• Assess for pregnancy and breast-feeding
• Hormones other than tamoxifen (Nolvadex) may be palliative rather than curative
o Important that both client and family understand this limitation
• Development of cross-gender secondary sexual characteristics
o Common, yet distressing, side effects of sex-hormone therapy
• Fertility sometimes affected
• Discuss these effects frankly with client, and offer support

47
Q

Nursing Implications: Natural Products

A

• Assess allergy to plants or flowers, including herbs or foods
• Vincristine (Oncovin) may produce acute bronchospasm and skin rashes
• Inquire if female clients are pregnant or breast-feeding
• Many of same cytotoxic effects as other antineoplastics
• Emphasize need to establish nutritional plan to combat constipation
o High fluid and fiber intake
• Monitor blood pressure
• Observe clients for symptoms such as headache, dizziness, or syncope
• May produce severe mental depression; assess possibility of suicidal ideation

48
Q

Adverse effects of therapy (general for all of them… serious)

A

• Alopecia
• Mucositis (severe nausea, vomiting, diarrhea)
 Drugs with high emetic potential pretreated with antiemetics (Compazine, Reglan, Ativan)
Vesicants
 Can cause tissue injury (extravasation)
 Know emergency treatment before giving vesicants IV
Long-term consequences
 Possible infertility
 Increased risk for secondary tumors

49
Q

Nursing Implications: Immunosuppressents

A

 Contraindicated in client with leukemia, metastatic cancer, active infection, renal or liver disease or those who are pregnant
 Obtain vital signs and results of lab testing to provide baseline data
 Monitor for indications of infection
 Monitor degree of bone-marrow suppression (thrombocytopenia and leukopenia)
 Monitor clients taking azathioprine (Imuran) for development of secondary malignancies

50
Q

Nursing Implications for Immunization Agents

A

 Assess for risk-based precautions: pregnancy, diabetes, heart disease, renal failure
 Provide education on importance of receiving vaccinations
 Answer questions and concerns regarding risks and benefits of vaccines
 Instruct on recommended immunization schedule and follow-up vaccines

51
Q

A Vaccine provides

A

ACTIVE immunity.

Pharmacology Exam 3 KS (4 decks)

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